EP0108635B2 - Absorbable bone fixation device - Google Patents

Absorbable bone fixation device Download PDF

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Publication number
EP0108635B2
EP0108635B2 EP83306762A EP83306762A EP0108635B2 EP 0108635 B2 EP0108635 B2 EP 0108635B2 EP 83306762 A EP83306762 A EP 83306762A EP 83306762 A EP83306762 A EP 83306762A EP 0108635 B2 EP0108635 B2 EP 0108635B2
Authority
EP
European Patent Office
Prior art keywords
monomer
catalyst
polymer
bone fixation
polymers
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Expired - Lifetime
Application number
EP83306762A
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German (de)
English (en)
French (fr)
Other versions
EP0108635A2 (en
EP0108635B1 (en
EP0108635A3 (en
Inventor
Deger C. Tunc
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Johnson and Johnson Hospital Services Inc
Original Assignee
Johnson and Johnson Products Inc
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Publication date
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Application filed by Johnson and Johnson Products Inc filed Critical Johnson and Johnson Products Inc
Publication of EP0108635A2 publication Critical patent/EP0108635A2/en
Publication of EP0108635A3 publication Critical patent/EP0108635A3/en
Publication of EP0108635B1 publication Critical patent/EP0108635B1/en
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Publication of EP0108635B2 publication Critical patent/EP0108635B2/en
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    • C—CHEMISTRY; METALLURGY
    • C08—ORGANIC MACROMOLECULAR COMPOUNDS; THEIR PREPARATION OR CHEMICAL WORKING-UP; COMPOSITIONS BASED THEREON
    • C08G—MACROMOLECULAR COMPOUNDS OBTAINED OTHERWISE THAN BY REACTIONS ONLY INVOLVING UNSATURATED CARBON-TO-CARBON BONDS
    • C08G63/00—Macromolecular compounds obtained by reactions forming a carboxylic ester link in the main chain of the macromolecule
    • C08G63/02—Polyesters derived from hydroxycarboxylic acids or from polycarboxylic acids and polyhydroxy compounds
    • C08G63/06—Polyesters derived from hydroxycarboxylic acids or from polycarboxylic acids and polyhydroxy compounds derived from hydroxycarboxylic acids
    • C08G63/08—Lactones or lactides
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
    • A61L31/00—Materials for other surgical articles, e.g. stents, stent-grafts, shunts, surgical drapes, guide wires, materials for adhesion prevention, occluding devices, surgical gloves, tissue fixation devices
    • A61L31/04—Macromolecular materials
    • A61L31/06—Macromolecular materials obtained otherwise than by reactions only involving carbon-to-carbon unsaturated bonds
    • Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
    • Y10—TECHNICAL SUBJECTS COVERED BY FORMER USPC
    • Y10S—TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
    • Y10S606/00—Surgery
    • Y10S606/907—Composed of particular material or coated
    • Y10S606/908—Bioabsorbable material
    • Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
    • Y10—TECHNICAL SUBJECTS COVERED BY FORMER USPC
    • Y10S—TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
    • Y10S606/00—Surgery
    • Y10S606/907—Composed of particular material or coated
    • Y10S606/91—Polymer

Definitions

  • This invention relates to a process for forming internal bone fixation devices which are made of very high molecular weight polymers of L(-)lactide. These devices are absorbable in the human body and need not be removed after the bone has healed.
  • bone fixation devices are made of metals. These metal devices are employed in severe bone fractures where it is necessary to secure the ends of the fractured bones in proximity of each other so that they may properly heal. These devices are generally in the form of intramedullary rods and pins and plates and screws. The major problem with such metal bone fixation devices is the desirability, if not necessity, of removing the devices after the bone has completely healed. The surgical procedure necessary for the removal of such devices results in additional trauma to the patient as well as increased medical costs.
  • FR-A-1,425,333 discloses a process for forming a high molecular weight polylactide polymer, comprising polymerising L(-)lactide monomer in an inert atmosphere in the presence of from 0.001 to 0.1% of a catalyst, at a temperature of from 105 to 170°C.
  • a catalyst in the Examples, its monomer to catalyst ratios are 2476, 2476, 4975 and 1071 respectively.
  • the catalyst is a compound of the formula RMX, wherein R is a C1 to C12 alkyl group, M is a group II metal and X is R, or an alkyl- or aryl-oxy or carbonyloxy group.
  • the reaction times vary from a few minutes to 1.5 hours.
  • the present invention provides a process for forming a high molecular weight polylactide polymer as set out in Claim 1.
  • the bone fixation devices made by the process of the present invention may be in the form of configuration that are usually employed as metal bone fixation devices. These are plates which are used to secure a fracture in proximity so that it may be healed, screws which are used to affix the plates to the bones, wires, rods, pins, staples, cable ties and clips.
  • the particular configuration of the bone fixation devices is not a part of the present invention.
  • the devices made from the polymer disclosed herein are generally identical in their configuration as such devices made from metal but may be of somewhat greater thickness than the metal device.
  • the bone fixation devices produced according to the process of the present invention are made from a polymer of L(-)lactide, which polymer has an extremely high molecular weight as indicated by its inherent viscosity.
  • the devices made from such polymers will maintain load-bearing strength after implantation for a sufficient period of time for the bone to heal and assume its load-bearing capability.
  • the inherent viscosity of the L(-)lactide polymers produced according to the process of the present invention is between 4.5 and 10. Generally, these polymers have a weight average molecular weight in excess of one million. However, the molecular weight of the polymers is difficult to accurately determine, and inherent viscosity is used herein as a more reliable technique to characterize the molecular weight of the polymer.
  • the solid polymer from which the devices are fabricated must also have a low unreacted monomer content.
  • the presence of unreacted monomer in the devices causes rapid degradation of the polymer with the resulting rapid loss in the required strength properties of the bone fixation devices.
  • the unreacted monomer content in the polymer must be below 2%, and preferably below 1%, and most preferably at 0% or below the limits of detectability.
  • the conditions of polymerization must be very carefully controlled as will be hereinafter explained in greater detail.
  • the monomer to catalyst ratio and the temperature of the polymerization reaction are interdependent and must be controlled to produce a polymer with the desired properties.
  • the absorbable bone fixation devices produced by the process of the present invention are polymers of L(-)lactide.
  • the recurring unit in the polymer may be depicted by the general formula:
  • the lactide monomer must be free of impurities and free of moisture in order to obtain suitable polymers.
  • the bone fixation devices produced by the process of the present invention have a tensile strength of at least 49 MPa (500 kilograms per square centimeter) before implantation.
  • the polymer from which the devices are made will begin to degrade by hydrolysis and be absorbed by the body. As the polymer degrades, the device will lose its tensile strength. In order to be useable, the device must maintain its strength for a sufficient time for the bone to begin to heal and assume some portion of the load-bearing requirements.
  • the tensile strength and the shear strength of the implant, eight weeks after implantation should be at least 9.8 MPa (100 kilograms per square centimeter).
  • the polymers from which the devices are made must have a very high molecular weight.
  • the inherent viscosity of the polymers should be greater than 4.5 and preferably between 7 and 10 in order to meet the requirements set forth above.
  • Polymers with inherent viscosities between 4.5 and 7 may be used in some applications such as finger, wrist and other applications where there are relatively low load-bearing requirements.
  • Polymers with inherent viscosities lower than 4.5 may be acceptable for other surgical uses, such as in sutures or in vascular grafting material, but are of insufficient viscosity to provide an absorbable bone fixation device which will maintain load-bearing strength for the required length of time.
  • the reaction conditions for the polymerization be critically controlled.
  • the resulting polymers must also have very low residual unreacted monomer content.
  • the resulting solid polymers have a monomer content of less than one percent (1%) based on the total weight of the reaction product of the polymerization, although a monomer content of between 1% and 2% will be acceptable for some devices.
  • the catalyst that is used in the polymerization of the polymers of the present invention has been known to catalyze the present monomers.
  • the preferred catalyst is stannous octoate.
  • the amount of catalyst, as measured by the mole ratio of the monomer to the catalyst must be controlled in conjunction with the control of the reaction temperature of the polymerization.
  • the monomer to catalyst ratio is between 1,100 and 45,000, the most preferred ratio being between 1,300 and 20,000.
  • the polymerization is maintained at a reaction temperature of 105°-155°C, most preferably between 110°-130°C. It is, however, necessary to maintain the monomer to catalyst ratio in conjunction with the particular reaction temperature selected. That is, a high monomer to catalyst ratio with a reaction temperature at the lower end of the above range would result in high levels of unreacted monomer and an unacceptable polymer for the purposes of the present invention.
  • a high monomer to catalyst ratio with too high a temperature would result in an extremely low molecular weight polymer, which is also unsuitabie in manufacturing bone fixation devices.
  • a low monomer to catalyst ratio and a temperature at the lower end of the above scale results in nonuniform and thermally unstable polymers, which are also unsuitable for the present purposes. It is, therefore, necessary to maintain the ratio of monomer to catalyst in a range which is suitable for the particular temperature at which the polymerization reaction occurs.
  • stannous octoate is the preferred catalyst.
  • antimony trifluoride, powdered zinc, dibutyl tin oxide and stannous oxalate may also be used as catalyst to produce high molecular weight polymers.
  • the polymer produced by the process of the present invention is preferably made from 100% L(-)lactide monomer. However, minor amounts, i.e. 10% or less, of compatible comonomers may be polymerized with the L(-)lactide. Suitable comonomers include:
  • the process according to the present invention for preparing the polymers includes charging the monomer and the proper amount of catalyst into a glass reactor under dry conditions, such as under a flow of dry nitrogen in a glovebox.
  • the glass reactor is then evacuated for 15 minutes at extremely low pressures, such as 2.67 Pa (0.02 millimeter of mercury).
  • the reactor is then refilled with dry nitrogen, and the evacuation is repeated twice.
  • After the reaction flask is evacuated for the third time, it is sealed.
  • the polymerization is then carried out in a controlled temperature oil bath while the contents of the reactor are magnetically stirred. As the polymerization proceeds, the viscosity of the reaction product increases until the point is reached that the magnetic stirrer can no longer be turned.
  • the reaction time in order to produce a polymer having the stated characteristics, is between 50 and 120 hours.
  • the solid polymer is removed from the reaction vessel, and is machined using ordinary machine tools or the polymer is ground and molded to form the desired fixation device which would be used for implantation.
  • the polymerization reaction conditions necessary to produce an acceptable polymer are depicted in Figure 1 which plots reaction temperature in degrees Celsius versus monomer to catalyst ratio ⁇ 103 on a semi-log scale.
  • the area within the enclosed curve B are those reaction conditions which will result in the high inherent viscosity, low monomer content polymers which are generally suitable for absorbable bone fixation devices.
  • Those polymers have the most desired in vivo properties and are capable of maintaining load-bearing properties for extended periods of time. These polymers can be used to fabricate fixation devices for use in high load-bearing applications such as the bones in the arms and legs.
  • Example 1 The procedure of Example 1 was used except that the amount of L(-)lactide used in the polymerization was 373 g and the monomer/catalyst ratio was 1413. The polymerization temperature was maintained at 105°C and the polymerization time was 69.5 hours. The polymer obtained exhibited an inherent viscosity of 5.26 and an intrinsic viscosity of 5.50.
  • Example 2 illustrates how the inherent viscosity of poly L(-)lactide is affected by varying the monomer/catalyst ratio.
  • the procedure of Example 1 was used but the amount of L(-)lactide was 300 g in all the batches.
  • the monomer/catalyst ratio and polymerization temperature are summarized in Table I together with the inherent viscosity and the percent of unreacted monomer in the final polymer.
  • This example illustrates the effects of polymerizing L(-)lactide at higher temperatures and at high and low monomer/catalyst ratios.
  • This example illustrates the rate of shear strength decrease of the polymer of Example 2 in Buffer-7 at 37.8°C.
  • Test specimens were prepared from this polymer in the form of pins, 15 mm long and 3-4 mm in diameter. The results are shown in Table III. TABLE III Shear strength and hardness as a function of time Period in test. sol. Diameter mm (inch) Shear strength kg (Ibs) Shear strength MPa (psi) Hardness at 0.01 penet.
  • This example shows the effect of the molecular weight on the in vitro tensile strength of certain polymers identified in Table IV with time. Samples of each of the polymers were placed in a Buffer 7 solution at 37°C. The samples were rectangular blocks 20 mm long, 3 mm wide and 1 mm thick. Samples were removed at various times, and the tensile strength determined. The results in Table VI show that a high molecular weight is necessary in order for the polymer to have adequate tensile strength at 8 weeks in vitro.
  • the samples were placed in Buffer-7 at 37°C and individual samples were removed and tested for shear strength after varying time periods.
  • the samples were implanted in the back muscles of rats, removed and tested for shear strength. The results of the in vivo test are shown in Figure 4, and the results of the in vitro test are shown in Figure 5.

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  • Health & Medical Sciences (AREA)
  • Chemical & Material Sciences (AREA)
  • Chemical Kinetics & Catalysis (AREA)
  • Vascular Medicine (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Organic Chemistry (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Surgery (AREA)
  • Medicinal Chemistry (AREA)
  • Epidemiology (AREA)
  • Polymers & Plastics (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Materials For Medical Uses (AREA)
  • Polyesters Or Polycarbonates (AREA)
  • Surgical Instruments (AREA)
EP83306762A 1982-11-08 1983-11-07 Absorbable bone fixation device Expired - Lifetime EP0108635B2 (en)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US06/439,962 US4539981A (en) 1982-11-08 1982-11-08 Absorbable bone fixation device
US439962 1982-11-08

Publications (4)

Publication Number Publication Date
EP0108635A2 EP0108635A2 (en) 1984-05-16
EP0108635A3 EP0108635A3 (en) 1985-05-29
EP0108635B1 EP0108635B1 (en) 1988-06-08
EP0108635B2 true EP0108635B2 (en) 1996-01-10

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ID=23746845

Family Applications (1)

Application Number Title Priority Date Filing Date
EP83306762A Expired - Lifetime EP0108635B2 (en) 1982-11-08 1983-11-07 Absorbable bone fixation device

Country Status (10)

Country Link
US (1) US4539981A (el)
EP (1) EP0108635B2 (el)
JP (2) JPS5997654A (el)
AU (1) AU561150B2 (el)
CA (1) CA1230195A (el)
DE (1) DE3376983D1 (el)
ES (1) ES8605831A1 (el)
GR (1) GR81278B (el)
NZ (1) NZ206057A (el)
ZA (1) ZA838283B (el)

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EP0108635A2 (en) 1984-05-16
JPS5997654A (ja) 1984-06-05
EP0108635B1 (en) 1988-06-08
GR81278B (el) 1984-12-11
JPH0889567A (ja) 1996-04-09
US4539981A (en) 1985-09-10
ZA838283B (en) 1985-06-26
JPH0316866B2 (el) 1991-03-06
DE3376983D1 (en) 1988-07-14
EP0108635A3 (en) 1985-05-29
AU561150B2 (en) 1987-04-30
NZ206057A (en) 1986-02-21
CA1230195A (en) 1987-12-08
ES527068A0 (es) 1986-04-01
ES8605831A1 (es) 1986-04-01
JP2786997B2 (ja) 1998-08-13
AU2104383A (en) 1984-05-17

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